Subacromial Impingement Syndrome (SIS) is characterized by abnormal scapular motion, including decreased upward rotation, increased internal rotation, and excessive anterior tilting, which impair shoulder and arm function. Integrated scapular rehabilitation combines Instrument-Assisted Soft Tissue Mobilization (IASTM) and postural correction exercises. IASTM detects soft tissue restrictions through multidirectional strokes and enhances the pain threshold of myofascial trigger points (MTrPs) via reflex hyperemia. Postural correction exercises aim to strengthen weakened muscles and stretch tight ones to improve stability and posture. The combination of these interventions may enhance scapular stability and dynamic control. This study aimed to investigate the effects of integrated scapular rehabilitation on scapular kinematics, movement correction, functional improvement, and pain management in tennis athletes with SIS. A two-way repeated-measures ANOVA was used to analyze pre- and post-intervention effects.
a VAS score greater than 3 during the Hawkins test (indicating mild to moderate pain),
at least two positive results among the Hawkins test, Neer test, and painful arch test, and
a positive result on the mSAT. Only participants who fulfilled all three criteria were enrolled in the study.
Participants were excluded if they had a history of clavicle, scapular, or humeral fractures; shoulder dislocation; or rotator cuff surgery; positive results on the cervical compression test, apprehension test, or drop arm test; had received corticosteroid injections within the past three months; had undergone physical therapy within the past six months; or reported a VAS score higher than 9.
Parallel
Instrument-Assisted Soft Tissue Mobilization
DeviceIASTM is an assistive instrument designed to reduce the physical effort required by the practitioner and can be applied without a specific directional pattern. It aims to induce localized reactive hyperemia through repeated application, temporarily alter tissue rheological properties, and modulate sensory feedback via cutaneous mechanoreceptors. Its mechanisms involve both mechanical and neurophysiological components.
Elastic band
DeviceElastic resistance bands of different colors were used for resistance training, with training intensity increased or decreased by selecting bands of varying resistance levels.
Pain (VAS score during the Hawkins test)
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